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Pathological processes > Neoplasia 4 > Flashcards

Neoplasia 4 Flashcards

1
Q

most common cancer in men

A

prostate

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2
Q

most common cancer in women

A

breast

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3
Q

symptoms of cancer

A

lethargy weight loss loss of apetite

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4
Q

most cancers are diagnosed in people over the age of

A

65

  • takea a long time for intitiationa dn promtoion to turn into a malignant neoplasm
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5
Q

in children younger than 14

A

leukaemis, CNS tumour and lymphomas are common

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6
Q

1/2 of people diagnosed with cancer in Uk will surive their disease for

A

10 years or more

(higher in women)

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7
Q

testicular cancer survival (5 years)

A

98%

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8
Q

melanoma surivival (5 year)

A

90%

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9
Q

survival rate of pancreatic (5 years)

A

1%

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10
Q

why is survival increasing

A

better diagnosis

  • screening etc
  • better education so people will come to doctors

better targeted therapy

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11
Q

which cancers shown little improvement in survival from 19702

A

lung and pancreas

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12
Q

which cancer is the worst for mortality in both men and women

A

lung cancer

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13
Q

how are outcomes predicted

A

age

general health status

tumour site

tumour type

differentiation

tumour stage

availability of effective treatments

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14
Q

age

A

older people bhave weakened immune system and tolerate treatment less well

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15
Q

cancer type

A

e. g. basal cell carcinoma never metastasise
e. g. melanoma will metastise even when small

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16
Q

what is used to stage solid tumours

A

TNM staging system

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17
Q

T stands for

A

tumour

  • size of primary tumour
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18
Q

N stands for

A

node- extent of regional lymph node involvement

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19
Q

M stands for

A

metastatic

  • metastatic spread via blood
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20
Q
A
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21
Q

T1 is

A

the smallest tumour

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22
Q

T4

A

is the the biggest tumour

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23
Q

N0

A

no lymph nodes invovles

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24
Q

N1

A

1 lymph node involved

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25
Q

N3

A

all involved

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26
Q

M0

A

no metastasise

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27
Q

M1

A

there are metastasise

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28
Q
A
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29
Q

each cancer has its own

A

specific TNM criteria

30
Q

tumour stage is a measur eof the

A

overall burden of the malignant neoplasms

  • coverted to a stage 1-4
31
Q

stage 1=

A

early local disease

32
Q

stage 2=

A

advanced lcoal disease (N0,M0)

33
Q

stage 3=

A

regional metastasis (N1 or more with M0)

34
Q

stage 4=

A

advaned diseasde with distant metastasis (M1)

35
Q

example of TNM staging for breast cancer

A
36
Q

Anna arbor staging system

A

Lymphoma staging system based in the USA

stage 1 lymphoma= single node

stage 2= two nodes invovled but on the same side of the diaphragm

stage 3= multple lymph nodes invovled but on both side of the diaphragm

stage 4= invovlement of lympahtic organs e.g. bone marrow or lungs

37
Q

duke staging system

A

for bowel cancer (can also use TNM now)

38
Q

grading

A

describes the degree of differentiation of a neoplasm

  • how closely it resembles its tissue of origin e.g. squamous cell carcinoma
39
Q

G1

A

well differentiated

40
Q

G2

A

moderlalty differneitated

41
Q

G3

A

poorly differentiated

42
Q

G4

A

undiffernetiated or anaplastic (cant recongise where the tissue comes from)

43
Q

G1 vs G3 surival

A

more likely to surive if lower grade

44
Q

Gleasons pattern

A

for prostate cancer

45
Q

`Grading helps ifnorm

A

treatment

  • each if the mass is moderately differentiated - watch and wait
  • if the mass is poorly differentiated- surgery
46
Q

treatments for cancer

A
  • Surgery
  • Radiotherapy
  • Chemotherapy
  • Hormone Therapy
  • Treatments targeted to specific molecular alterations
  • Immunotherapy
47
Q

surgery

A

most successful treatment for cure

  • good for early tumours which have not metastised
  • want to remove tumour and have clear margins
48
Q

which cancers require chemotherapy instead of surgery

A

lymphoma and leukemia

49
Q

adjuvant therapy

A

treatment given after surgical removal of a primary tumour to eliminate subclinical disease

50
Q

neoadjuvant

A

treatment is given prior to surgical excision to reduce the size of the primary treatment

51
Q

radiation therapy

A

kills proliferating cells by tirggering apoptosis or intefering with mitosis

  • kills rapidly dividing cells in G2 of the cell cycle
  • causes either direct or free-radical idncue DNA dmaage that is detected by cell cycle checkpoints triggering apoptossis
  • doube stranded DNA breakages causes damaged chromsosmes that prevent M phase from completing correctlty
52
Q
A
53
Q

how is radiation therapy given

A

given in fractionated dosease to minimise normal tissue damage

-with lead shields- targeted therapy so doenst damage normal tissue

54
Q

what happens if you give one large dose of radiation vs multiple smaller doses

A

give healthy cells time to repair between therapies

55
Q

chemotherapy types

A
  • antimetabolites
  • alkylating and platinum based drugs
  • antibiotics
  • plant derived drugs
56
Q

antimetabolites

A

mimic nromal substrate invovled in DNA replication

  • e.g. fluorouracil
57
Q

alkylating and platinum based drugs

A

cross link ghe two strands of the DNA helix

  • cyclophosphamide
  • cisplatin
58
Q

antibiotics

A
  • doxorubicin inhibit DNA topoisomerase needed for DNA synthesis
  • bleomycin causes double stranded DNA breaks
59
Q

plant dervived drugs

A

block microtubules assemble and interers with mitotic spindle formation

  • vincristine from periwinkles
60
Q

effects chemotherapy has on the body

A

affects systems with rapidly proliferating cells

  • hair loss (hair cells)
  • pain
  • mouth sores (mucosa)
  • trouble breathing
  • nausea and vomiting (GI tract)
  • weakened immune system (bone marrow)
  • bruising and bleeding
  • constipation/ diarrhea
  • rashes
  • neuropathy
61
Q

hromone therapy example

A

selective oestrogen receptor modulators (SERMS)

e. g. Tamoxifen
- binds to eostrogen receptors preventing oestrogen from binding to its receptors
- used to treat hormone receptor positive breast cancer

62
Q

targeting oncogenes

A
  • Identifying cancer specific alterations such as oncogene mutations allows us to create targeted drugs specifically at cancer cells
  • Trastuzumab (Herceptin)
  • Imatinib (Gleevec)
63
Q
A
64
Q

immunotherapy

A

targets immune system to help it fight cancer by recognising and attacking cancer cells

65
Q

cancer immunity cycle highlights

A

points where immune treatments can be used

e.g. immune checkpoint inhibitors

66
Q

tumour markers

A

various substances released by cancer cells into the ciruclation (and urine and faeces

67
Q

tumour marker measurment

A
  • somtimes used for diagnosiss
  • most useful for monitoring tumour burdne during treatment and follow-up
  • assess recurrence
68
Q

examples of tumour markers

A

– Human Chorionic Gonadotrophin - testicular tumours

– Alpha fetoprotein – hepatocellular carcinoma

– Prostate specific antigen – prostate carcinoma

– CA125 – ovarian cancer

69
Q
A
70
Q

cancer screening

A

meant for healthy people with no symptoms

  • attempt sto detect cancers as early as possible when the chance fo cure is the highest
71
Q

what screening programmes are available in the UK?

A

Breast screening
– Women, 47 – 73 years of age

Cervical screening
– Women, 25-64 in UK
– Every 3 years for women aged 25-49 – Every 5 years for women aged 50-64

Bowel screening

– Home testing kit: Men and women aged 60-74

– Bowel scope screening: Offered to men and women at the age of 55 in some parts of England

72
Q

problems with screening

A
  • over diagnsosis (would the cancer ever have caused a clinical problem)
  • lead time bias
  • lag time

Pathological processes (19 decks)

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